Division of Colorectal Surgery

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Diverticulitis and Diverticulosis

In the colons of most people, small pouches bulge outward through weak spots, like an inner tube pushing through weak places in a tire. Each pouch is called a diverticulum (pouches are diverticula). The condition of having diverticula is called diverticulosis. About half of all Americans age 60 to 80, and almost everyone over age 80, has diverticulosis.

When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are together called diverticular disease.

If you or a loved one has received a diagnosis of diverticular disease and would like a second opinion to confirm this diagnosis or discuss treatment options, please see our second opinion section.

Symptoms of Diverticulosis and Diverticulitis

Diverticulosis typically causes little or no discomfort, and most people with diverticulosis are unaware of their condition. Cramps, bloating, and irregular bowel movements may be mild symptoms. Diverticulitis usually causes pain in the lower left abdomen. If diverticulosis is caused by infection, then a person may also experience fever, chills, nausea, vomiting, cramping, and constipation. Moreover, numerous complications can develop from chronic diverticulitis, including diffuse peritonitis, localized abscess, fistulas (such as a colovesical or colovaginal), and obstruction of the colon.

Causes of Diverticular Disease

Diverticulosis is most often caused by inadequate dietary fiber; it is one of the most common diseases in the US, England and Australia, and results from modern-day low-fiber diets. Many people are able to improve diverticular disease by increasing the quantity of fiber in their diets, such as by increasing their consumption of whole grains (such as whole wheat as opposed to refined white flour), fresh vegetables, and fresh fruits.

Treating Diverticular Disease

If dietary changes are not sufficient, treatments for acute diverticulitis may also include oral or intravenous antibiotics, a liquid diet, bed rest, and medications to stop muscle spasms in the colon. In severe cases, and when repeated attacks affect function and quality of life, surgery may be required.

Surgery for Diverticulitis at Columbia University Medical Center

Our surgeons use laparoscopic techniques and care pathways to ensure best practices and facilitate rapid recovery and return to activity after surgery for diverticular disease. The potential immediate and long-term benefits and risks of operative and non-operative management are assessed on a case-by-case basis to determine management.

The manifestations of diverticulitis and its impact on overall health and quality of life can be variable and distressing. Guidelines for the best management of this condition continue to evolve. Our surgeons have extensive experience with the treatment of diverticulitis and strong interest in the latest developments related to the condition. One of our surgeons is involved at the national level in the development of consensus guidelines for its management, placing our division in a unique position to offer an evidence-based individualized approach to the management of this difficult condition.